Gum (Periodontal) Disease
What is Periodontal Disease?
Bacteria in plaque cause periodontal (gum) disease. If allowed to stay on the teeth, plaque can cause your gums to become red and swollen. This is called gingivitis.
In some cases, the disease will progress to a more severe form of gum disease known as periodontitis. This is where the gum next to the plaque peels away from the tooth, forming a “pocket”. The bone beneath this pocket is eaten away and lost permanently.
Unlike gingivitis, periodontitis is not reversible, and if allowed to progress, more and more bone loss will occur. This bone supports your teeth, so this destructive process can result in loosening of the teeth and eventually even their loss.
1. Inflamed Gum 2. Plaque & Calculus 3. Pocket 4. Bone Loss
Do I have periodontal disease?
The classic symptoms of periodontal disease are:
Red, swollen gums that often bleed on brushing
Persistent bad breath
Receding gums
Drifting of teeth that gradually become loose
Does everyone get gum disease?
Everyone is prone to the early form of gum disease (gingivitis), but people vary in how prone they are to the more severe form (periodontitis).
Factors increasing the risk of acquiring periodontitis are:
Poor plaque control
Smoking
Family Link (Hereditary)
Some diseases, such as diabetes
Certain medications, such as immunosuppressants
Periodontitis can cause health
problems beyond the mouth
Several studies have shown a link between periodontitis and:
Heart disease
Controlling blood sugar
Pre-term babies
Low birth-weight babies
Osteoporosis
Alzheimer’s disease
What should I do if I think I have periodontitis?
Your dentist and hygienist can detect and monitor gum disease. If you attend regularly, it should be picked up at an early stage. They will show you the correct cleaning techniques necessary for you to use daily and carry out scaling. If your case is more advanced or does not respond to treatment by your dentist, then you should be referred to a periodontist.
What is a periodontist?
A periodontist is a specialist dentist who has been trained in the diagnosis, treatment and prevention of gum disease.
What Are the Benefits of Periodontal Treatment?
The removal of plaque and tartar will resolve the inflammation within the gums and help “zip” the pocket gum tissue up against the teeth. The shallower the pockets become, the more likely it is for the condition to be stable. Treating periodontitis will help both create a healthy mouth and prevent the loss of teeth. There is also evidence that controlling periodontitis can help improve the blood sugar levels in diabetics.
Once it has been controlled, will periodontitis ever return?
Unfortunately, this condition can recur. Therefore, it is essential that you are carefully monitored and that you see your hygienist regularly for routine scaling appointments.
A periodontist is a specialist dentist qualified to diagnose, treat and prevent gum disease.
What happens if my teeth fall out or have to be removed?
If your teeth have fallen out or need to be removed due to the extent of tissue destruction, the spaces can be restored. The treatment options are a denture, a bridge (if the teeth supporting the bridge are strong and healthy enough) and dental implants; a thorough assessment is required to establish which restorative treatment options are appropriate.
Dental implants should only be placed once the periodontal condition of the whole mouth is stable. Without gum health around all remaining teeth, there will be an increased risk of developing the equivalent of periodontitis around the dental implants and increase the risk of failure around them.
Detailed information on Gum Disease
Gingivitis
Everyone is susceptible to gingivitis. Gingivitis, which is gum inflammation, is caused by the presence of plaque, leading to red, swollen, and often bleeding, tender gums.
Over time, persistent plaque can calcify on the teeth, forming a hardened porous deposit known as tartar.
The treatment for gingivitis involves removing plaque by a dental health professional, along with maintaining a good standard of daily dental hygiene by the individual.
Plaque can be removed through tooth brushing and cleaning between the teeth, but once it hardens into tartar, these deposits require removal by a professional cleaning from a hygienist, dental therapist, or dentist.
It is a reversible condition, as the removal of plaque and tartar will eliminate all signs and symptoms of gingivitis.
Periodontitis
Although not everyone is susceptible to periodontitis, it is common, being in fact the sixth most common disease in the world. Approximately half of us exhibit some degree of periodontitis, and about 10% of the world’s population displays a severe form of the disease. It mainly occurs in adults; it can start at any age within adulthood.
Periodontitis occurs if gingivitis does not resolve due to the continued presence of plaque, allowing the bacteria to spread along the tooth surface, including below the gum line. This plaque eventually eats away at the gum tissue connecting to the tooth surface, peeling the gum away to form a space below the gum line, called a pocket, and this destruction results in bone loss and possibly gum recession.
As the plaque continues to spread down the side of the tooth, the pocket increases in depth. The deeper the pocket, the larger the reservoir of plaque that can be contained within the pocket. Unless treated, the affected tooth can become loose, and in some cases, can be lost.
The extent of periodontitis can vary from person to person, and its rate of destruction can vary within that individual. In some cases, the individual is free from any symptoms, but in those that do, the most common symptoms are the following:
Red, swollen gums
Tender gums, which are prone to bleeding
Spontaneously bleeding gums. For instance, blood may be noticed on the pillow.
Loose teeth
Receding gums, resulting in the apparent lengthening of teeth.
Drifting teeth, possibly leading to a change in which the teeth meet when biting together.
Bad taste
Persistent bad breath
Sensitive teeth.
Is everyone prone to periodontitis?
Although plaque is the only actual cause of periodontitis, habits like smoking and vaping, as well as conditions such as diabetes and certain autoimmune diseases, can increase people’s susceptibility to the condition. There is also a link between periodontitis and cardiovascular disease, rheumatoid arthritis, dementia, and osteoporosis.
Periodontitis can cause gum tenderness, swelling, recession, and loose teeth. Unlike gingivitis, periodontitis is not reversible, and if allowed to progress, it can lead to significant bone loss, increasing the risk of loose teeth. Increased mobility of teeth can sometimes reduce the ability to chew or even prevent the patient from eating completely with the affected teeth. Severe bone loss can eventually result in tooth loss.